Pancreatic Health

("Don't call it calories, call it food") #1

Hi there,

Please forgive me if I have missed some informative posts in my search. I am a 35 year old woman with hypothyroidism and stubborn weight. I have no gallbladder (it ended up necrotic and was removed 11 years ago). I have a history of pancreatitis - once when I had my gallbladder removed, and once in January 2018 when I started a ketogenic diet.

I began keto in the new year and loved it - most of my fat consumption in the first two weeks was coconut oil. I then started adding large amounts of dairy to my diet, and I ended up with an attack of acute pancreatitis.

I am struggling mightily to a) lose weight and b) control my cravings and my desire is to try keto again. I know that coconut oil and MCT oil are easy on the pancreas. I take bile supplements and enzymes when I eat.

Has anyone had experience with this type of situation? I saw one link to an article from the UK (i think?) that suggested that high triglycerides were the cause of pancreatitis. Can anyone disscuss how the mitigate the potential damage a very high fat diet can cause to your pancreas and gallbladder??

I am aware that my pancreas isn’t happy with high carb either - I just need to be very careful as my history means that I am at high risk for future attacks.

I do not drink alcohol.


Pancreatitis worse from keto
Checking In with Update
(Bunny) #2

Sounds like your not having a problem digesting plant based fats vs. animal based fats right now which is good? If you are in fact taking MCT oil right now? Some people are not so fortunate (can be fatal?)…


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  1. Newly Dx Insulin Resistant, Fatty Liver despite 3+yrs keto and 4mths IF/EF -wait, what?
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  1. High Triglycerides & Pancreatitis
  1. Triglyceride-induced Pancreatitis: Diagnostic and Therapeutic Approach

("Don't call it calories, call it food") #3

Thank you so much! I look forward to reading these… I have read the Dr. Joncker’s article but not the others.

Yes I am lucky I can digest food fairly well at the moment. I am on my phone and will check out your past posts later - do you have issues with pancreatitis?

(Bunny) #4

Just curious about the “food” comment; do you mean “food in general” or ‘ability to digest fats’ ???

I do not have any pancreatitis issues that I am aware at this time, this is kind of a GREY AREA on the forum and should be addressed very thoroughly, it is very important and can be life-threatening because eating or attempting a high-fat diet is not good if the pancreatitis issue should arise during or prior to starting a ketogenic diet?

Need to address and conquer (very difficult) the pancreatitis issue first before starting keto?

("Don't call it calories, call it food") #5

You are correct, I should have specified fat. At this point I have worked out that I need significant vitamin and nutrient supplementation to function during the day. Given that, I suppose I should qualify my statement and say that I digest fat and food well because I supplement with enzymes, bile, and a number of vitamins and nutrients. Which, honestly, really means I don’t digest food all that well :-). I have chronic malabsorption issues, and I’m on an incredibly high dosage of bioidentical hormone treatment for my thyroid condition.

I take your point about being careful which is why I haven’t attempted keto since January. However, I’m about 25 pounds overweight and I am seemingly unable to lose it through calorie restriction or diet change. This is mainly because I struggle tremendously to stick to a moderate carb diet. When I was on keto for about a month, I had no problems sticking to the method.

I’m concerned that in the long run my excess weight and my insulin resistance will be more damaging to my health than my pancreatic concerns. I understand that my thyroid condition is linked to my lack of gallbladder, and I wouldn’t be surprised if it is also linked to the inability to properly digest fat soluble vitamins that is partially caused by pancreatic problems. I am trying to understand from my reading just how a keto diet could be beneficial to me. I’m aware of the potential health hazards of overloading my pancreas. My instincts, however, is that if I try to limit most of my fat intake to coconut oil and MCT oil, I might be able to manage it.

I’m not want to gamble with my health. I feel miserable that I am not able to easily control my eating when I attempt to maintain moderate carbs. Surely the answer is that I just need to do a better job. I long, however, for the ease of Keto and wish that I could come up with a way to do it.

I also know that I don’t necessarily have to eat high-fat in order to be in ketosis, though I’m not sure what that would look like in the long run.

As for conquering my pancreatic issues, I’m not even sure that is feasible as I have no idea of the underlying causes. No scans and tests demonstrated anything conclusive. I can only assume that my particular body could not cope with the overload of dairy fat I consumed during my last two weeks of Keto.

(Bacon is a many-splendoured thing) #6

Since I am neither a physician nor a nutritionist, you should take my musings with a grain of salt (literally or figuratively, as you prefer, lol!), but I just can’t see a low-carb, high-fat diet stressing the pancreas. Surely the lower insulin level needed from eating such a diet ought to be a relief to the pancreas, oughtn’t it? I am wondering if perhaps you were already headed for pancreatitis, and it was just coincidence that it flared up when you went keto.

I tolerate dairy well, myself, but a lot of people on these forums have posted about problems that were solved by eliminating dairy from their diet. Is it possible that your bout of pancreatitis was caused by too much dairy? You might want to try a ketogenic diet again, however without the dairy this time. You could cook with lard or tallow instead of butter, and get your fat from fattier cuts of meat, rather than from cream and cheese. Try, however, to keep your protein moderate, and find ways of keeping your fat consumption up with saturated fat.

P.S.—Forgot to add that pancreatitis is nothting to fool around with, so keep in touch with your doctor, if you try going keto again.

("Don't call it calories, call it food") #7

Thanks Paul, I appreciate the musings :slight_smile:

Yes, I think the dairy was the primary culprit. There is a concern, however, that a high-fat diet will stress the pancreas. High fat diets require the pancreas to secrete high levels of lipase as part of its exocrine function. The low carb component is certainly a benefit to the pancreas with regards to the endocrine function, I would surmise (though part of me wonders what long-term keto does to the body’s ability to manage the endocrine system effectively if carbs are re-introduced - are there studies or experiences with this that anyone knows about?).

For people who suffer from chronic pancreatitis (which I do not, yet), the prescribed diet is extremely low-fat, lean protein, and light, frequent food intake. Serious sufferers have to survive on liquid. The pancreas begins, over time, to digest itself and/or suffer from extreme inflammation if you over-tax it with difficult-to-digest foods. Pancreatitis is extremely painful - I have birthed three children naturally, and I would put the pain up at that level.

I have in the past 10 years (since my last bout of pancreatitis) eaten large quantities of fatty meats without much problem (though, in retrospect, my liver wasn’t too happy). I am not normally a consumer of lots of dairy… I drink about 1.5 cups of raw milk a day in my tea (over the course of the day), but cheese, yogurt, cream, etc, were rare in my diet.

I am going to start the journey into keto tomorrow, with a focus on lots of veggies, lean protein (chicken breast, fish, some lean pork) and get my added fat from MCT oil and coconut oil. These oils are now on the list of suggested items (in extreme moderation) for people with chronic pancreatitis as they tend not to trigger lipase production (or only limited lipase production?).

As for following up with my doctor-------- I have so many thoughts on that, it is hard to respond. The standard next step in my care would be a somewhat invasive internal MRI type scan that has a high tendency to puncture/penetrate/aggravate your pancreas and trigger acute pancreatitis. I am loathe to do this. The doctors recommend a variation on low fat/high carb diet. I do not believe, given my knowledge of my body, that this is good for me. My blood sugar swings wildly (I have suffered from hypoglycemia in the past and have had periods of tracking blood sugar). It has been a financial strain dealing with my medical issues, and the thought of trying to get an endocrinologist on board with a LCHF or even LC moderate fat diet is more than I think I am capable of at this point.

This is not to say I disagree with you - I think it would be sensible to monitor my numbers as I try this out. But I am not up to that challenge (I stay home with three small boys and cannot often get childcare for doctor’s visits). So, I will have to monitor my symptoms. I am setting up a tracking document and I am going to plan out my meals and see if I can figure out what my own limits are. The symptoms of pancreatitis are fairly clear, so I should be able to know if I am triggering a problem.

That being said - if anyone has walked this path before me, please please chime in! Or even if you haven’t, and you have thoughts, I am all ears. I have appreciated the comments thus far.

(Ron) #8

Sounds as though you have researched well on your condition so this might be irrelevant but thought I would share anyways.

("Don't call it calories, call it food") #9

Thanks Ron, That was interesting. I wonder what science will turn up in my lifetime about this condition…


I suffer from acute pancreatitis that is caused by high triglycerides. Lipase and ldl levels go through the roof during an attack. I’ve been trying the Keto diet for about two months now. First two weeks, great results, but then I went on a girls holiday and cheated. When I got back I got back on the diet and within a week I was having pains in my diaphragm as if an acute pancreatic attack was beginning. The same radiating feeling. It didn’t get to full pain or hospitalisation and I managed to deal with it with painkillers. Had myself a few weeks off from strict Keto but started again this week. Today, I have horrid pain again. I think the Keto diet is brilliant for losing weight but there are definitely complications if you suffer from pancreatitis that is caused by sensitivity to high fat / triglycerides / lipase / cholesterol etc. Not sure what to do either. Carbs make me sluggish and swollen, and now with the pancreatic damage I’m not entirely sure how insulin is managed in the body, and the Keto diet might be triggering these mini attacks. And my local GP’s just don’t seem to be interested in understanding Keto or pancreatitis. It’s very frustrating.

(Edith) #11

Maybe it is the cheating that is causing your trouble? Maybe because of the risk of pancreatitis you need more consistency with the diet? Just an idea…

("Don't call it calories, call it food") #12

Edith, I know that in my case, cheating is what ultimately set me over the edge and into the hospital. With pacreatitis, there can’t be any cheating for me! But, if I am not careful, the diet does negatively impact my pancreas. @Misterstraps you might find some relief trying keto the way I mentioned - leaner protein, no dairy, and try to get most of your fat through Coconut Oil and MCT oil… Not sure that will deal with the high triglycerides, but perhaps you might have some idea if that will help based on your own past experience.


I also thought that maybe the breaks might have been the problem. (Though I felt much better during those breaks). But actually I just think (and so does the doc) it’s the high fat content that triggers the elevation of triglycerides that in turn triggers the pancreatitis. Such a shame as I was losing a lot of weight on Keto.

(Edith) #14

I’m saying this without being a sufferer of pancreatitis, so ignore this if I am full of bologna: two weeks on keto was not enough time for your body to adjust to the new foods and become fat adapted. Fat adaptation can take as many as two months or maybe even a little longer. You may have felt better when you went off the diet because your body was glad to be back to having carbs; just like an addict who is going through withdrawal feels better when restarting their drug.

Maybe ease into the fats: start with lower fat protein and slowly increase fats so your gallbladder and pancreas have time to adjust. I was recently reading up on pancreatitis because I had having stomach issues and it does run in my family along with gallbladder issues. Pancreatitis can be caused from a blockage of the gallbladder duct causing the pancreatic enzymes to back up and start digesting the pancreas. Maybe slowly increasing fats will ease the way for both organs? Maybe you will find you have a fat tolerance that you can’t go over.

(Ron) #15

This ^^^^^^^^

Withdrawals are going to happen when you stop an addiction. So many think starting Keto is easy, you just have to cut out carbs. In reality, is can be a very difficult transition and takes determination to succeed.

("Don't call it calories, call it food") #16

Withdrawals are certainly something to push through… Pancreatitis is not. For one thing the pain is worse than childbirth, so it isn’t something you can just ignore. Also it has severe long-term health consequences… If I feel my pancreas flairing up, I have to adjust.

Yes I agree about determination to succeed. It may be that I can make this work long term, and perhaps the other people who have posted with pancreatic issues. But, it may not work… Fat consumption is directly linked with pancreatic problems in those of use with compromised pancreases. Keto is high fat, or at least moderate fat… I am pushing on (day 25) but I am not guaranteed to succeed even if I push through and have determination.

(Edith) #17

I apologize if I implied pushing through pancreatic pain. I should have reread the original post about when you were feeling the discomfort.

Again, my apologies.

("Don't call it calories, call it food") #18

Oh Edith I wasn’t responding to you and I wasn’t offended or upset so no need to apologize! Sorry if my tone was off, it wasn’t meant to be!

(Ron) #19

Then I too will apologize as I followed up on her comment, although I wasn’t really directing my response to you as more of a blanket statement about Keto in general for newbie’s that might be following this thread.
Again, sorry if it sounded negatively towards you.

("Don't call it calories, call it food") #20

Oh wow please don’t apologize! Goodness I should add more smiley faces to my posts. It takes a lot to offend or upset me… I appreciate all responses!